Managing hoarding and squalor

Abstract

Hoarding and squalor are complex conditions with a range of physical and mental comorbidities.GPs play a key role in identifying people who experience these conditions, screening for safety risks, referral to specialist services and encouraging people to accept treatment and ongoing monitoring. Treatment for contributing and comorbid conditions should be optimised, with the help of specialist services when required. Medicines should be reviewed and adherence confirmed.For moderate to severe hoarding and squalor, referral to specialist psychiatry, geriatrics and allied health services is recommended for thorough assessment, treatment of underlying conditions and ongoing management.

An Investigation into the Prevalence of Methamphetamine Related Enquiries to Local Government Environmental Health Officers

“…Similar to hoarding and squalor cases, which are also managed by local government EHOs, clandestine labs are multifaceted situations which often include financial problems, child and/or animal neglect, and public health safety concerns [32][33][34]. For hoarding and squalor cases, many of these problems arise from a combination of physical impairment and mental health issues [35]. Contact with these services is initiated by EHOs; however, many stakeholders are required to be involved to resolve a hoarding and squalor case; these include (but are not limited to) rubbish removal contractors, law enforcement, and community health services [9,36].…”

Household factors and prevalence of squalor: meta-analysis and meta-regression

“…For the individual, squalor can lead to physical safety risks, difficulty accessing and receiving services and associated isolation [10] and a raft of associated physical health problems [11,12]. Furthermore, squalor creates significant problems for the individual's family and their neighbours [13,14]. The evidence base for squalor is thin, as it tends to be too narrowly focused on adults over 65 years old [15][16][17][18], has small sample sizes, is over-reliant on cross-sectional methods [15,[18][19][20], rarely have a control group, uses case identification approaches that lack reliability and validity [15,16,18,19] and creates data not pertinent to the focus of the study [19][20][21][22].…”

Characteristics of Older People from a Poor Residential Environment in Okinawa, Japan: An Emergency Department-Based Cross-Sectional Study

“…A poor residential environment (PRE) often results from hoarding behavior, of which a feature might meet hoarding disorder criteria as specified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), characterized by “persistent difficulty in discarding or parting with possessions due to distress associated with discarding, urges to save, and/or difficulty in making decisions about what to keep and what to discard” [1]. Another relevant problematic behavior of those from a PRE is self-neglect, for example, defined as “inability, due to physical or mental impairment or diminished capacity, to perform essential self-care,” in the 2010 Elder Justice Act, although there are various conceptual and operational definitions worldwide [2].…”